TITLE

Exposure-in-vivo containing interventions to improve work functioning of workers with anxiety disorder: a systematic review

AUTHOR(S)
Noordik, Erik; van der Klink, Jac J. L.; Klingen, Elmer F.; Nieuwenhuijsen, Karen; van Dijk, Frank J. H.
PUB. DATE
January 2010
SOURCE
BMC Public Health;2010, Vol. 10, p598
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Anxiety disorders are associated with functional disability, sickness absence, and decreased productivity. Effective treatments of anxiety disorders can result in remission of symptoms. However the effects on work related outcomes are largely unknown. Exposure in vivo is potentially well fit to improve work-related outcomes. This study systematically reviews the effectiveness of exposure-in-vivo containing interventions in reducing work-related adverse outcomes in workers with anxiety disorders. Methods: A systematic study search was conducted in Medline, Cinahl, Embase and Psycinfo. Two reviewers independently extracted data and from each study assessed the quality of evidence by using the GRADE approach. We performed a meta-analysis if data showed sufficient clinical homogeneity. Results: Seven studies containing 11 exposure-in-vivo interventions were included. Four studies were focused on Obsessive Compulsive Disorder (OCD), two on Post Traumatic Stress Disorder (PTSD), and one on a mixed group of OCD and severe phobias. The studies were grouped according to type of anxiety disorder and subsequently according to type of comparisons. For OCD, exposure-in-vivo containing interventions can yield better work-related outcomes compared to medication (SSRIs) and relaxation but not better compared to response prevention. The results on anxiety outcomes were similar. The net contribution of exposure in vivo in two OCD intervention programs is also presented as a meta-analysis and shows significant positive results on work role limitations. The calculated pooled effect size with 95% confidence interval was 0.72 (0.28, 1.15). For PTSD, exposure-in-vivo containing interventions can yield better work-related and anxiety-related outcomes compared to a waiting-list but not better compared to imaginal exposure. Conclusions: Exposure in vivo as part of an anxiety treatment can reduce work-related adverse outcomes in workers with OCD and PTSD better than various other anxiety treatments or a waiting-list. We recommend that it should be studied how the results of these studies can be transferred to the practice of occupational health professionals and how clinicians can make better use of them to improve work-related outcomes. In future research, priority should be given to high-quality randomised controlled trials (RCTs) in which exposure-in-vivo containing interventions are applied to a variety of anxiety disorders and compared with other clinical anxiety treatments such as SSRIs. Work-related outcomes, in particular work functioning and sickness absence, need to be assessed with reliable and valid measures.
ACCESSION #
55099836

 

Related Articles

  • Guía clínica naturista de la ansiedad y crisis de pánico. Galve, Juan José Gálvez // Medicina Naturista;jul-dic2008, Vol. 2 Issue 3, p215 

    Use of complementary and alternative medicine has increased over the past decade. There is well documented evidence for the increasing widespread use of complementary and alternative medicine in the treatment of anxiety and with panic attacks. Some of the reasons for the use of CAM include the...

  • Protocol for a randomised controlled trial investigating the effectiveness of an online e health application for the prevention of Generalised Anxiety Disorder. Christensen, Helen; M.^Griffiths, Kathleen; J^Mackinnon, Andrew; Kalia, Kanupriya; J.^Batterham, Philip; Kenardy, Justin; Eagleson, Claire; Bennett, Kylie // BMC Psychiatry;2010, Vol. 10, p25 

    Background: Generalised Anxiety Disorder (GAD) is a highly prevalent psychiatric disorder. Effective prevention in young adulthood has the potential to reduce the prevalence of the disorder, to reduce disability and lower the costs of the disorder to the community. The present trial (the WebGAD...

  • Determinants of Barriers to Treatment for Anxiety Disorders. Chartier-Otis, Mariko; Perreault, Michel; B�langer, Claude // Psychiatric Quarterly;Jun2010, Vol. 81 Issue 2, p127 

    The objectives of this study were to evaluate perceived unmet need for mental healthcare, determinants of unmet need, and barriers to care in individuals with social anxiety (SA) or panic disorder with agoraphobia (PDA) in Quebec. Data from 206 participants diagnosed with SA or PDA were...

  • Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Grant, B. F.; Goldstein, R. B.; Chou, S. P.; Huang, B.; Stinson, F. S.; Dawson, D. A.; Saha, T. D.; Smith, S. M.; Pulay, A. J.; Pickering, R. P.; Ruan, W. J.; Compton, W. M. // Molecular Psychiatry;Nov2009, Vol. 14 Issue 11, p1051 

    The objective of this study was to present nationally representative findings on sociodemographic and psychopathologic predictors of first incidence of Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) substance, mood and anxiety disorders using the Wave 2 National...

  • Classification of neurotic disorders. Andrews, Gavin // Journal of the Royal Society of Medicine;Oct1990, Vol. 83 Issue 10, p606 

    The author reflects on the classification of neuroses on the basis of community survey conducted in England, Australia, Canada, New Zealand and the United States. Anxiety disorder, phobias and panic disorders were found to be the most common illness in the surveyed population. The cognitive...

  • Careful classification contributes significantly to the understanding and management of neurotic disorders: a debate. Roth, Martin // Journal of the Royal Society of Medicine;Oct1990, Vol. 83 Issue 10, p609 

    The article discusses how classification of neuroses helps understand and manage the diseases. Correct interpretation of various forms of anxiety and depressive illness is required to classify neuroses. There is a need for the clear understanding of words such as anxiety and depression, and...

  • When anxiety strikes. Gallagher, Jean; Lyons, Declan // World of Irish Nursing & Midwifery;Nov2005, Vol. 13 Issue 10, p29 

    Presents information on the management of anxiety disorder. Diagnostic criteria set by the Diagnostic and Statistical Manual-IV International Classification of Diseases-10 for social anxiety; Symptoms of anxiety disorder; Treatment for social anxiety.

  • PHOBIA THERAPY: LEARNING HOW TO DEAL WITH FEAR AND THE FEAR OF FEAR. Meer, Jeff // Psychology Today;Apr85, Vol. 19 Issue 4, p30 

    The article reports on how to deal with phobias which can result from anxiety attacks, can grow out of specific experiences, and which can be learned from others. Broadly classified, there are three categories of phobias which include simple phobias, social phobias and agoraphobia. One of the...

  • Mental Health: Anxiety and Panic Disorders.  // Mayo Clinic Guide to Self-Care;2005, p197 

    Presents health care tips about anxiety and panic disorders. Signs of panic attack; Treatment options for panic attacks; Involvement of the human body's fight-or-flight response to danger on panic attack.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics